Active NPI
Robert C. Hubbard III
- Pharmacist
- Clemson, SC
National Provider Identifier
1982721502
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 003716
- Practice address
- 402 College Ave
Suite 1
Clemson, SC 29631-2923 - Phone
- (864) 654-1771
- NPI assigned
- Mar 26, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 003716 | SC | Primary |
Addresses
Primary practice location
402 College Ave
Suite 1
Clemson, SC 29631-2923
Mailing address
402 College Ave
Suite 1
Clemson, SC 29631-2923
Phone (864) 654-1771
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 742748 | Medicaid | SC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003716 | SC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1982721502",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "402 COLLEGE AVE",
"address_2": "SUITE 1",
"city": "CLEMSON",
"state": "SC",
"postal_code": "296312923",
"telephone_number": "864-654-1771"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "402 COLLEGE AVE",
"address_2": "SUITE 1",
"city": "CLEMSON",
"state": "SC",
"postal_code": "296312923",
"telephone_number": "864-654-1771"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUBBARD",
"first_name": "ROBERT",
"middle_name": "C.",
"name_suffix": "III",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "SC",
"license": "003716",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "742748",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clemson, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.